Individual
MARY ANNA STACIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
151 HAZARD AVE, ENFIELD, CT 06082-4584
(860) 763-8044
(860) 272-2990
Mailing address
151 HAZARD AVE, ENFIELD, CT 06082-4584
(860) 763-8044
(860) 272-2990
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
001652
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
CT
Enumeration date
03/28/2008
Last updated
05/10/2026
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